Autism or Something Else? Differentiating Autism from Similar Conditions

Overview: This article explains common diagnoses that are similar to autism, or that autism can be mistaken for. At the end there is a chart explaining the differentiating symptoms for each of the conditions.   

Autism is a complex disorder with a myriad of symptoms, many of which may signify the presence of other mental health disorders in addition to autism. Below is a list of similar diagnoses and how their symptoms compare to autism spectrum disorder (ASD). These are stand-alone diagnoses that are distinct from autism (except for pathological demand avoidance and Aspergers, which are/were subtypes of autism). Psychological testing is often done to differentiate these similar diagnoses. The similarities are green, and the differences are red. This information is not intended to be used for diagnosis, rather to show the similarities and differences between certain disorders. 

●      Social (Pragmatic) Communication Disorder

• Poor conversational give and take

• Trouble with figurative language

• Struggle to form strong relationships

• Not as much rigidity as autism

• No visual-spatial-motor problems

• No restricted interests or repetitive behaviors 

●      Nonverbal Learning Disorder

• Strength in verbal communication, but weakness in non-verbal communication

• Trouble reading social situations 

• Non-verbal struggles are negatively impacting socializing and other parts of life

  • At least 1 area of life is negatively impacted in addition to social struggle– fine motor skills, direction finding, executive functioning, etc. 

• Missing social cues in individual conversations 

• Problems with visual-spatial-motor skills – especially fine motor skills

• No restricted interests or repetitive behaviors

●      Social Anxiety

• Common symptoms include excessive self-consciousness, fear of negative judgment, and avoidance of social interactions.

• People with social anxiety do not necessarily have repetitive behaviors, restricted interests, or other social or cognitive deficits. 

• They likely have had socially successful times in their life. 

●      Schizotypal Personality Disorder

• Social isolation and discomfort in close relationships are common.

• It is characterized by peculiar behaviors, beliefs, and interpersonal difficulties.

• Individuals with STPD may have eccentric thought patterns and exhibit unusual perceptual experiences.

• People with STPD often have magical thinking, odd beliefs, and may be overly superstitious.

• People with STPD do not necessarily have repetitive behaviors, restricted interests, or other cognitive deficits. 

●      Schizoid Personality Disorder

• They may seem emotionally indifferent and unresponsive in social situations.

• It is characterized by persistent social detachment and emotional coldness.

• Individuals with SPD often prefer solitude and have limited interest in close relationships.

• People with SPD might appear content with their solitary lifestyle.

• People with SPD do not necessarily have repetitive behaviors, restricted interests, or other cognitive deficits. 

●      Asperger’s Disorder:

• This subtype of Autism was absorbed into the Autism Spectrum after the 2013 revision of the DSM. It is akin to someone being on Level 1 Autism and having no history of language impairment. 

●      Pathological Demand Avoidance

• All autism symptoms are present.

• A rare behavioral phenotype of ASD that is typified by an overwhelming need to resist or avoid demands that is often due to overwhelming anxiety. 

• Defiance towards demands can lead to anger outbursts and extreme discomfort.

• Primarily present in younger populations because of the uncomfortable social pressure that people experience as they age.